The Good Doctor (2017) s01e05 Episode Script

Point Three Percent

1 Previously on "The Good Doctor" ETHAN: How hard can it be to just act like a normal human being?! - [GRUNTS] - No! Stop petting that stupid rabbit! - [THUD] - We're never going home again.
We have each other, and that's all we need.
SHAUN: My brother went to heaven in front of my eyes.
STEVE: Never forget, you're the smart one.
And I'm proud of you, Shaun.
[TELEVISION PLAYING] [KNOCKING ON DOOR] [BIRDS CHIRPING] [KNOCKING CONTINUES] KEVIN: Dad? Hey! [LAUGHS] Yeah, I missed you, too! Oh, Penny, come.
Stay.
Hey, Dad.
Sorry it's so early.
I just landed.
Actually, you're a bit late.
Five weeks.
I know.
I know.
- I'm sorry.
- I-I-It's a long story, okay? But h-how was it? It was your mother's funeral.
Dad, I'm [EXHALES SHARPLY] Okay.
Well, um, you have my cell number.
It only works if you answer it.
[SIGHS] [THUMPING, GLASS SHATTERING] Dad? Dad?! - [WHEEZING] - Dad! Hey, hey! Hey you okay? You okay? You can't breathe?! No? No.
Okay.
I'm gonna call for help.
[WHEEZING] Yeah, 911? My dad collapsed! He can't he can't breathe, please hurry! Just hold on, Dad! [INDISTINCT P.
A.
ANNOUNCEMENT] Good morning, everyone! Right on time.
What, did you sleep here or use a teleportation device? I used a teleportation device.
[LAUGHS] Nonsensical questions usually imply sarcasm, which I've found people often answer sarcastically.
Good one.
Trauma wants a consult on a 66-year-old male who collapsed from severe anaphylaxis, complicated by respiratory arrest.
His son just got back from Thailand.
Almost immediately, the father had his allergic reaction.
MERRILL: [GROANING] Patient has a few allergies pollen, mold, shellfish but no corresponding allergens were in evidence.
Why are we doing a surgical consult on an allergy? Well, we're not.
We're doing a consult on the excruciating abdominal pain he now has.
[GROANING LOUDLY] As you may have heard.
Mr.
Wilks, hi, I'm Dr.
Neil Melendez.
Heard you had some abdominal pain.
The guy was in some serious pain 10 milligrams of morphine worth.
Test results show elevated lipase, amylase, pancreatic enzymes.
Pancreas is enlarged.
Could be pancreatitis, maybe alcohol-induced.
The son said he smelled alcohol on his father at 6:00 in the morning.
And anaphylaxis has been known to precipitate attacks of pancreatitis.
Guess that's it, then.
Meaning you totally disagree.
Not everyone who starts their day off with a Mimosa fries their pancreas.
Your eyesight must a hell of a lot better than mine.
Because I can't see the entire pancreas due to the overlying bowel gas.
We'll order an abdominal C and take a better look.
There you go.
Where the hell is Murphy? It's a severe fracture, but I don't think you'll need pins.
Young bones tend to heal very well.
Young Bones? Isn't that a "Star TREK: Origins" graphic novel? I'm not sure.
No, that was a joke.
Where are your parents? They're coming.
They both work in the city, so it's a long drive for them.
I was on a school field trip, and I tripped over my own feet.
Of course, it was right in front of Shelby Lomar.
At least it was pretty gross, so I got some sympathy points for that.
I would expect this to have been caused by a more serious accident.
Nope, just a trip.
I do that a lot.
What can I say? I'm clumsy.
Yes.
Now follow my finger.
You have some nystagmus an involuntary eye movement.
So what's that mean? When you fell, did you hit your head? No.
What, you think I have brain damage? Nystagmus can be a sign of a neurological issue.
Oh.
Well, that would explain the "C" I got in social studies.
That was another joke, wasn't it? Mm.
I'm going to order a head CT for you.
Go for it.
Shaun, are you getting any sleep? - Yes.
- Really? I mean, really getting sleep? I got here on time.
Well, that's good.
I used a teleportation device.
Radiology form, please.
Shaun, that boy, he looks like Steve.
He does.
Is he related? His name is Evan Gallico, so I don't think so.
Wow.
That is uncanny.
Just coincidental.
He looks exactly like your brother.
No, he doesn't.
His hair is shorter.
It freaks me out.
It doesn't freak you out? No.
- It's okay if it does - No, he's not Steve.
Steve's dead.
"I used a teleportation device" was a joke.
Yeah, that's that's good.
[INDISTINCT P.
A.
ANNOUNCEMENT] KEVIN: So, I couldn't come to Mom's funeral because I fell in love.
She was another teacher at the school.
A Thai woman.
And she was kind and and beautiful and loving and very, very sick.
She had a congenital heart defect.
Look, if you don't want to tell me where you've been for the last six months, then don't.
It's your business.
But don't insult my intelligence.
Well, I couldn't just leave her.
You couldn't leave her for five minutes to make a phone call? [KNOCKING ON DOOR] This a bad time? No, come in.
According to the CT, you have a lesion on your pancreas.
Well, what do you think this lesion could be? Not sure.
That's why we need to biopsy it.
It could just be a benign cyst.
Or? Or it could be cancer, right? We'll know soon enough.
This won't take long.
EVAN: I know.
I've had two of these.
One more and I get my Scout badge.
[CHUCKLES] That was funny.
Tough to tell without looking at you, but I'm guessing that was sarcasm.
No.
I have autism, which makes it hard for me to read social cues.
Jokes are difficult.
I used to know a kid with autism.
Peter.
He was kind of weird but super nice.
Used to know? You don't know him anymore? He died.
Hit by a car.
You know anyone who died? My brother.
That sucks.
Why did you have the other CT scans? My parents have uh, what's the word for fear of getting sick? Hypochondriasis? Mm, no, worse than that.
They have nosophobia.
I love that word.
What do you think of Miss Gannett? She's nice.
I think she's callipygian.
She's what? Callipygian? It means "having shapely buttocks," Shaun.
Duh.
You read the dictionary.
What it lacks in plot, it makes up for in vocab.
So, you married? Girlfriend? Boyfriend? Tropical fish? I like Lea.
Ooh.
And who's Lea? Lea is a friend.
A friend you date? A friend with benefits? I lend her batteries sometimes.
I like where this is going [MACHINE BEEPS] So, you know, keep going.
'Cause if you don't, I will.
It's kind of my thing, you know? Just constant talking annoys everyone.
- Murphy.
- Well, I guess not everyone.
Hey.
My family's pretty used to me now.
I mean - Hey.
- [BUTTON CLICKS, BEEPS] my friends are very talkative as well, so You're giving the fractured arm a head CT? - Yes.
- Get back to the pancreas.
He's not clumsy.
He has a brain tumor behind the inner ear.
Forget the pancreas.
Mr.
and Mrs.
Gallico? - Hi.
- Hi.
I'm Dr.
Shaun Murphy.
I'm treating your son.
Well, how is he? We were told it was a bad break, but it should heal no problem.
I know why Evan tripped.
He had a tumor in the temporal bone behind his left ear, which is affecting his balance.
I've arranged for a consult with Dr.
Najid in oncology - and she's going - No, that won't be necessary.
We We already have an oncologist.
[SIGHS] Evan's been diagnosed with stage four osteosarcoma.
He was complaining of a sore shin.
The last thing that we expected was bone cancer.
The doctors at SFM, they gave him a year to live.
That was seven months ago.
Osteosarcoma explains the severity of his fracture he will need pins in his arm after all.
Uh, can we see him? Yes.
He's in room 414.
Uh, Dr.
Murphy? He doesn't know about his diagnosis.
We would really like to keep it that way.
He's the patient.
Doesn't he have the right to know the truth? Well, no.
He's also a minor, so, no, he doesn't.
Evan's very intelligent he'd be able to handle it.
Well, Shaun, maybe it's not just about Evan.
Maybe it's about his parents, as well.
Maybe it's just too difficult for them to tell Evan right now.
I don't know.
Then they're the ones who shouldn't be told.
Well, let me ask you this, Shaun what's so wrong about Evan being allowed to enjoy as much of his life as possible? Evan wants to know the truth.
How do you know that? If this were Steve, if this were your brother, would he want to know the truth? Is that what this is? Dad's such a tool.
I found my birthday present in their closet, right where they always hide it.
I was just about to open it when Dad caught me snooping and freaked out.
I hate all that phony surprise stuff.
It's an AquaBlast Water Cannon.
I was with Mom when she bought it.
Thank you, Shaun.
Your honesty's refreshing! Yes, he would want to know the truth.
Well, there's nothing we can do about it.
It's not your decision it's theirs.
He's their son.
- [DOOR BEEPS] - [SIGHS] Claire, I need you.
Sure, what's up? I need someone to lie for me.
Okay I'm flattered? Hey, doc? There's something I need to tell my dad.
We haven't moved him.
He's still in room, uh, 326.
Do you have a medical question for me? Is he dying? We don't know yet.
The biopsy will tell us more.
Okay.
My dad is a good guy.
We've just never been on the same page, you know? My mother was the one that I could talk to same for him.
So, without her, we're both pretty useless.
Room 326.
Right.
Dr.
Murphy called me in for a second opinion.
Um, you need some pins in your arm.
Why? What's changed? Well, after studying the radiology report, given how bad the break is, we just think it would be a prudent step to ensure an efficient and thorough mending to the break.
Will I be able to play baseball again? Well, I don't see why not, once it's completely healed, after some physiotherapy.
How long before I can pitch? It's hard to say.
[MONITOR BEEPING] He wanted someone to lie for him.
And he picked you.
[SCOFFS] Merrill's son asked for personal advice.
And he picked you.
I know, right? [SCOFFS] He's lying to his dad about something.
Yeah? What? I don't know.
You didn't ask? It didn't seem relevant, medically.
You know it's not that difficult to be a human being.
Just tell him to "come clean," "honesty is the best policy," "a lie is a stone in your heart.
" Who said the last one? Me.
I made it up.
Hmm.
[CHUCKLES] And I got it.
- [BEEPING QUICKENS] - He's anaphylactic.
- Would you get me an epi? - I'm coming out.
- The throat's constricting.
- Pull the tube! [GASPING] [SAW WHIRRING] [WHIRRING STOPS] So, what's up with "Dr.
Browne"? She's Lea, isn't she? Claire is my colleague.
Oh, come on, I saw the way you were looking at her.
How? I don't think I look like that.
Okay, so then why'd you call her in for a "consult"? Mm Okay.
Yes, she's better at talking to people than I am.
Wow.
I counted like 50 tells there.
- You really suck at lying.
- I know.
Too bad.
It's an important social skill.
So how do you know when to lie? When people need to know things, they need to know.
If they don't, lie through your teeth and feel good about it.
What if they need to know the truth, but it'll hurt them? Some can handle it, some can't.
So how do you know who can and who can't? You tell the truth.
If they like you after, then you'll know.
If they don't? Then it doesn't really matter anyway.
You have cancer.
[SIGHS] Yeah, I know.
My parents took me in for a sore leg.
After a whole bunch of tests, they talked to the doctor, then came out and told me I was fine.
That's it.
Just "fine.
" The next day, they bought me a PS4.
So I Googled my symptoms, and I narrowed it down to osteosarcoma or growing pains.
Kids don't get gaming systems for growing pains.
Hey, it's okay.
I'm not afraid to die.
You're not? Well, I mean, the dying part will suck if it hurts, but I'm not afraid about the actual death part.
Because you believe you're going to Heaven? Because I don't.
If I believe in Heaven, then I got to believe in God, then I got to believe God made me sick.
How messed up is that? It's just easier to think that it's all random and when it's over, it's just over.
So what about Lea? Where'd you guys meet? In the hallway.
That's a beautiful story.
Yes.
She's my neighbor.
Convenient.
He had another allergic reaction.
- The pancreas? - Merrill Wilks, yeah.
And the second attack was even more severe than the first.
It coincided with biopsying the pancreatic lesion, which now appears was a cyst.
Well, now we know he's allergic to whatever's in that cyst.
We also that the next cyst that pops - will probably kill him.
- Well, if there is a next.
Let's run a couple tests, see if there's any evidence of parasites.
And MRI his entire body if we're lucky, he only had the two cysts and he can go home.
Are you looking for loopholes? Hoping to save Evan? Everyone makes mistakes.
Which means you should double-check every file in the hospital.
The oncologist flagged his neutrophil count of 634 as low.
That is low.
Low normal.
I can still hear the word "low" in there.
Mm.
He's just a kid.
I know how hard it is to think of him dying.
He's okay with that.
I find that hard to believe.
We all die if we accepted that, we'd be happier.
Maybe.
But we're not good with contentment.
Fighting death is what keeps us alive.
[COMPUTER BEEPS] Okay.
We got a hit Echinococcus.
JARED: Echinococcus? The cysts are filled with tapeworms? Cysts? There are more? - Three more? - Four more.
You missed the one in his brain.
- [KNOCKING ON DOOR] - JARED: Dr.
Glassman? Yeah? You used to be a neurosurgeon, right? So they say.
Take this, will you? I need one.
Who would you recommend? What you got? Wow, that's cool.
How the hell did I get tapeworms in my head? No idea, but you do.
You can pick up the eggs from coyotes or wolves.
You been hanging around coyotes or wolves? I live in the suburbs we don't even have a petting zoo.
You might've had these cysts for quite some time.
When one of them burst, that's what caused the first allergic reaction.
Well, why did it burst? Why did it burst? Any sudden movements, twists, turns, squeeze.
A hug? Could be.
But you weren't there for the second one.
I punctured the cyst on your pancreas during the biopsy.
As you've seen, allergic reactions get worse each time they happen.
So a third one, that would be bad.
That would be [CHUCKLES] That would be very bad.
So we're gonna have to surgically remove all the cysts intact.
Dr.
Glassman's one of the most highly acclaimed neurosurgeons in the state.
You are very lucky to have him.
And Dr.
Kalu is fast becoming a very accomplished flatterer.
The cranial cyst, that is a big deal.
We're gonna have to take off the top of your skull.
You'd be digging in to my brain? Well, yeah, pretty much.
With saline.
We use it to gently displace the cyst, and then, poof, it magically pops out.
Kind of like delivering a baby.
You know, if childbirth were painless.
And then we move on to the other cysts.
Hey, we're gonna take good care of you.
Evan doesn't have cancer.
Cowards cowering in concrete showers in Rikers Island Victims, we the wolves that's wilding We often smilin' at sights of violence Acting brave and courageous Ain't advantageous for health and safety So when we say "run the jewels" It might not be cancer! And that goes for a guy or lady It might not be cancer! [MUSIC STOPS] Look at you on time two for two.
It might not be cancer.
- Fractured arm? - Yes.
You said he'd been diagnosed with stage four osteosarcoma.
Evan was diagnosed with the flu eight months ago, but his symptoms were actually a better fit with Epstein-Barr virus, which is linked to Langerhans cell histiocytosis, which causes osteolytic lesions in the long bones of the upper limbs.
And those lesions could be misdiagnosed as signs of osteosarcoma.
- Yes.
- What about his brain tumor? Langerhans can also manifest in the skull.
Instead of a death sentence, he could have something that could easily be treated with prednisone? Next, we need to do a bone-marrow aspiration to confirm.
I assume you've looked at his file.
For a very long time.
Well, there must've been a biopsy.
What did the pathology report say? Yes.
There were two biopsies.
Both were positive for osteosarcoma.
- Murphy - They could be false positives.
Do you have any idea how unlikely it is to have two false positives? 0.
3%.
Which we can comfortably round off to "not likely.
" It is possible Yes, but it means telling the parents of a dying child that there's hope, when really there isn't.
Grab a shower and get ready for rounds.
GLASSMAN: Wow.
[CHUCKLES] - Imaginative and creative.
- Yes.
What are the chances you're right? 0.
3%.
330 to 1.
333 to 1.
You really think that it's worth putting Evan's parents through all this? Of course.
If we did this 333 times, we'd be giving false hope to 332 people for approximately four hours, and we'd save one life.
- Isn't that worth it? - [EXHALES SHARPLY] Anyway, Dr.
Melendez won't let me ask for consent to test.
What if I don't tell them what I'm doing? A blatant ethics violation that's your solution? Yes.
How do I do that? [SCOFFS] Well, uh, [CHUCKLES] you do it and then don't tell anyone.
No one.
If anyone asks your attending noticed a low RBC count and needed to find the cause that's it no biggie.
Hmm.
[COUGHS] You know Wilks' Grocery on Santa Clara 17th? It's been an institution for nearly 60 years.
My grandparents started it in 1958, and my wife and I took it over in '82.
But when my wife got sick and I started talking to Kevin about taking it over, he just took off.
To him, it was just a place to sell lettuce and toilet paper.
My father chairs a real-estate development company in the U.
K.
Thought I'd be the perfect person to set up the U.
S.
office.
You wanted to be in the "helping profession," hmm? I wanted to be in my profession.
It's not about how small or how big the venture is, it's about doing something that's yours.
I guess.
When he was little, we were inseparable.
[CHUCKLES] Ah, he used to love to come to the store to "work.
" [LAUGHS] I even had a little apron made for him had his name on it, too.
Still, you know, kids grow up.
I'm just grateful that he stayed close to his mother.
He could talk to her, tell her anything.
[VOICE BREAKING] So could I.
And when she went [SOBS] I lost them both.
Looks like he's back now.
All I know is he ditched me when I needed him.
Well, you know, as a wise person once said, "holding a grudge is a stone in your heart.
" [SIGHS DEEPLY] What's that for? Local anaesthetic for a bonemarrow aspiration.
Why do I need a bonemarrow aspiration? My attending saw a low RBC count and wants to find the cause no biggie.
"No biggie"? You're lying.
What's going on? You already told me I have terminal cancer, what's worse than that? You might not.
It might not be osteosarcoma might be Langerhans cell histiocytosis, which is treatable.
Treatable? As in, I might not die? That's why I need to aspirate to find out for sure.
Do my parents know? Mm I was told not to get their hopes up.
Then let's do it before they get back.
Roll onto your side.
Is there a Scout badge for aspirations? [CHUCKLES] I think someone just made a joke.
Hello.
- What are you doing? - Painkiller.
My arm hurts.
That wouldn't explain why I'd be injecting your lumbar region.
Okay.
Yes, hello.
I think Evan may have been misdiagnosed with cancer.
I think he has something that creates bone lesions that look like osteosarcoma.
It's a small chance, 0.
3%, but I You You told Evan that he has cancer? And now you are telling him and us that he doesn't? I'm telling you he might not.
That's why I need to perform this aspiration.
He says whatever I have might be treatable.
- Are you insane? - No.
I am not insane.
I thought you'd be happy.
There is a significant link between Langerhans cell histiocytosis and Go! Get out! [COUGHING] Let me get you some water.
[COUGHING CONTINUES] [BREATHING SHARPLY] - Oh, my God! - Hands right here - [COUGHING] - All right, buddy.
Right here! Respiratory, stat! He has a massive embolus, probably thrown from his fracture.
It's located at the bifurcation of the pulmonary arteries.
He's close to hemodynamic collapse.
Yeah, no kidding.
I'd like to assist.
Not a chance.
Okay.
I'd like to assist.
You're obviously too close to the case.
I think I'm just the right amount of close.
Murphy, you lied to the parents just so you could try to prove your ridiculous theory.
You're too damn close.
Saddle embolism, scrub in.
MELENDEZ: We have to get rid of the embolus before he arrests.
His heart is barely pumping blood.
I can feel the pulmonary artery I just need to find the obstruction there! I got it.
- Knife.
- Knife.
EKG is showing right heart strain.
He can't take this much longer.
I know, but if I move any quicker, I could nick the left main artery and kill the boy.
The phrase "no biggie" gave me away.
You really got to learn how to lie, Shaun.
Am I in trouble? Yes.
Unless you're right.
If I'm wrong, they shouldn't be upset.
They know it's highly unlikely.
False hope, Shaun it's just plain cruel.
Hey.
He talk to you? Did you talk to him? I don't know what to tell him.
You love your father, don't you? Yeah, of course.
Right.
Well, he's about to go in for brain surgery.
There's huge risks involved.
Whatever this lie is, can you live the rest of your life knowing you kept it from him? My My girlfriend wasn't sick.
Okay? She dumped me.
She's married with two kids had no intention of leaving them.
I-I was an idiot.
You got your heart broken, that's the problem here? No no, Dad.
The problem is [SIGHS] I didn't run away to Thailand because I thought Wilks' Grocery was beneath me.
I was afraid that I would never be able to fill your shoes And then I proved myself right.
Left pulmonary artery's open.
Ring Forceps.
Ring Forceps.
Come on.
Got it.
[EXHALES SOFTLY] EKG is normalizing.
He's okay.
Nice job.
All right, flush the left pulmonary artery - and close him up.
- Okay.
Um Dr.
Melendez Take a look at this.
Recycling Shaun, very responsible.
It's a book.
I appreciate that.
[CHUCKLES] Thanks, Shaun.
[DOOR OPENS] Hey.
MELENDEZ: We got the embolism.
He's in recovery and he's doing fine.
But while we were in there, we did find something else.
Lesions on his ribs.
Irrefutable proof of osteosarcoma.
It's metastasized to his chest cavity.
I'm sorry.
[SIGHS] [SNIFFLES] [SOBBING] I'm very sorry.
[WHIRRING] [BEEPING] GLASSMAN: Give that a nice, warm saline bath.
Forceps and Taylor scissors, please.
- Forceps and scissors.
- Thank you.
Look at that.
That's what built the pyramids, painted the Mona Lisa, invented the Internet.
[EXHALES SHARPLY] And there is our interloper.
Squeezeball please, Deidre.
Squeezeball? His name for it, not ours.
The saline gently displaces the cyst and coaxes it out of its little hiding place Hopefully in one piece so we don't have to call 911.
Come on, now Tray, please.
There we go And And you got it.
Got it.
[EXHALES] He has his father's eyes.
That was incredible.
One down, three to go Hey.
There he is.
Hi, Sweetie.
What's the matter? Nothing.
We're just happy you did so great.
You had what's called an embolism.
It clogged an artery in your lungs.
But the good news is they got it.
And you're gonna be just fine.
Still too bad about the cancer, huh? No, no, no, no.
The doctor did not know what he was talking about Dad, I know all about it.
I have for a long time.
[INHALES DEEPLY] Well, I I am so sorry.
It's okay.
[SNIFFLING] Because I'm not gonna be alone.
Grandma's gonna be there, too.
Auntie Arlene.
Uncle Jim, if he figured out how to stop swearing.
[CHUCKLES] [CHUCKLES] [CLEARS THROAT] I'll get you some water, buddy.
So, I took Penny for a walk just around the block.
And I picked her up some of those rawhide treats, you know the ones that Mom used to like to give to her.
[VOICE BREAKING] I miss her, Dad.
EVAN: Coast is clear? Yes.
Thank you.
Mm, I was wrong.
You tried.
I was wrong.
Your parents hate me.
I know.
- I gave you false hope.
- Yeah.
But for a minute there, it was pretty awesome.
I'm going to ask you for a favor.
Well, I'm not giving away my Make-A-Wish.
Mm, would you mind if I read you something? It's not long.
That I can do.
"Atticus was right.
"One time he said you never really know a man "until you stand in his shoes and walk around in them.
"Just standing on the Radley porch was enough.
"The streetlights were fuzzy "from the fine rain that was falling.
"As I made my way home, I felt very old.
" I can't protect you from the course of life But you know me and you know I was born to try It's just the symptom of a middle-aged attack " while he hadn't done any of those things, "Atticus, he was real nice.
"His hands were under my chin, "pulling up the cover, "tucking it around me.
"Most people are, Scout, when you finally see them.
" "He turned out the light and went into Jem's room.
"He would be there all night, "and he would be there when Jem waked up in the morning.
" Sounds like a good book.
Could've used a spoiler alert, though.
Thank you.
Confusing you, from what you need Every hand that you hold It comes back That's all.
Every word, every ride It comes back every time It comes back every time Every time